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De�e 6-10-93 r„m�..wo,..n.•mn. 9•3 Z7�e � <br />Ap0liCelion For <br />eau o.o� • 40903 <br />PUBLIC WORKS PERMIT �°;o;,�:`� : <br />.,..� �.. P.,a s <br />Primor7ypeOnry Tft PfIGTINf, �-5-'�, a•�•^�•o,,. s 2�'^= _ <br />Paul Pritchard 1IJ1 Grandview Dr Everett liA 98206 252-9022 <br />pw�e� Mailing Atldress Ciry Zip Phone <br />Vlking Conet PO Box 7340 Evere[t 98201 259-7250 Dave Pedersen <br />ApPhcanl Mailing AEEress City Zip Phone <br />Descnbe PraDosed Wark neV QH2�0.e _ <br />Pra�ecl Atltlress �il known) <br />Dr <br />AUac� IOu� ��) copies ol Olans tor OropOsetl woik � Oraw to Scnle entl n0io Ihe lallawing as apphCa0le: <br />• Pmpetly Lines • Cenletline ol st�ect <br />• Outline anU dimensions ol ah exls!mg and • InUicete North <br />pe0poseA SIruL�ur85 On IhE 101 • S�aa nny p�oposetl qrad�nB c�anges <br />• E.isunp antl oropo,ad wii�ties • S�ow metsuremenis <br />PERMIT CONDITIONS <br />1. All calls lor inspectlon shall be matle 24 hrs. in edvance • phone 259$870. <br />2. All work a�ell be petlormetl In ectordance wit� IM5 permit and current City ol Everett OesiB� and Constmction <br />Slentlertls anC Spetiliw�ions. <br />3. Call Localion Untlerqround Service 4B hra. belore you tlig. TOLL FREE NUMBEN 1•800�424•5555. <br />� ��;��.�.� � �/y� <br />Annroved lo� Conslr tion �ale <br />) / / <br />/l� ��G/.I 7. a;7 _y� 7 <br />FINALINSP- TION Oate <br />ppp�ovetl ns Conslmcletl <br />I �Pl16LICWORNSDEPARTMENT <br />92C0 Cedar Streel <br />Evnrelt WA 90P01 <br />P�ore:459�8810 <br />ACKNOWLE�GGMENT OF CONDITIONS <br />W <br />H <br />N <br />� <br />O <br />� <br />N <br />O <br />a <br />Tl+e untler5ig^ed owner/applicant �ereby agrees to �oltl ane Save harm� <br />�ess I�e City at Everetl Irom any ana all claims lor dama8es. cosls. <br />e.pmses. or causes ol aclion Ihat may ense because ol mslallation <br />antl mOiNenante ol ihe improvement or othei rig��'OI'way use herelo <br />aPP��ed IOt dntl lurlher , grce5 t0 remove same upon nOlice Irom the <br />City antl lo rep/lace �pub/h��: proPerry damaBed IhereUy. <br />1 �-"""a' 1''�'�' ` _ ( %'�/ O 3 <br />,Signatu�e ol FpphWN �r" da ei <br />WORK AUiNORIZED BV TMIS P[HMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND TMEREAFTER IS TO <br />BE DILIGENTLV PURSUE� TO COMPLETION. THI$ PERMIT MAV BE <br />CANCELLEO BV TNE CITY UPON ANV STOPPAGE OF WORN ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />